Recurrence rate of endometrioma after laparoscopic cystectomy: a comparative randomized trial between post-operative hormonal suppression treatment or dietary therapy vs. placebo

To assess the recurrence rate of endometrioma after laparoscopic cystectomy plus hormonal suppression treatment or plus dietary therapy compared to post-operative placebo

Dietary therapy: a new strategy for management of chronic pelvic pain

Chronic pelvic pain (CPP) can be identified as a chronic nociceptive, inflammatory and neuropathic pain characterised by spontaneous pain and an exaggerated response to painful and/or innocuous stimuli. This pain condition is extremely debilitating and usually difficult to treat. Currently, the main approaches to treatment include counselling supported by reassuring ultrasound scanning or psychotherapy, attempting to provide reassurance using laparoscopy to exclude serious pelvic pathology, hormonal therapy and neuroablative treatment to interrupt nerve pathways. Dietary supplementation has been suggested as a means to treat chronic medical illnesses that are poorly responsive to prescription drugs or in which therapeutic options are limited, costly or carry a high side-effect profile. A comprehensive search of the PubMed database was performed using the search terms 'chronic pelvic pain', 'oxidative stress', 'antioxidants' and 'dietary therapy'. The systematic review focuses on both randomised and non-randomised controlled trials from 2005 onwards, in which CPP was the end point. Given the complexity and not well-understood aetiology of CPP, its treatment is often unsatisfactory and limited to partial symptom relief. Dietary therapy with antioxidants improves function of the immune system and in fighting free radical damage. Agents with antioxidant activity are able to improve CPP without undesired effects and any important metabolic changes associated with hormonal suppression therapy. In conclusion, dietary therapy with antioxidants could be considered as a new effective strategy in the long term for CPP, and may be better accepted by patients. Further randomised trials with larger series and long-term follow-up to confirm these observations are needed

Insulin glargine in enteric tube feeding.

Diabetes Res Clin Pract. 2007 Nov;78(2):298-9. Epub 2007 May 3. Insulin glargine in enteric tube feeding. Marchetti G, Tesauro M, Di Daniele N, Bollea MR, Lauro R, Bertoli A. Insulin glargine, a long-acting insulin analogue, was introduced to provide effective basal insulin replacement with once-daily dosing. An insulin regimen with insulin glargine allows optimal glucose control with a lower risk of hypoglycaemia compared with neutral protaminated hagedorn insulin in Type 2 diabetes [1,2]. Recently, insulin glargine has been proposed for patients on continuous enteral artificial nutrition [3,4]. We report an 18-month follow-up of a patient treated with basal insulin glargine during continuous enteral nutrition and thereafter during intermittent enteral nutrition without evidence of hypoglycaemic events

The prediction of total body water and extracellular water from bioelectric impedance in obese children

Objectives: To assess the reliability of bioelectric impedance analysis (BIA) for predicting total body water (TBW) and extracellular water (ECW) in obese children. Design: Comparison of five prediction models based on: (i) body weight (Wt), (ii) the impedance (Z) index (ZI=height(2)/Z), (iii) the association of Wt and ZI, (iv) the body surface area (SA) to impedance ratio (SA:Z) and, (v) the body volume (V) to impedance ratio (V:Z). Subjects: Thirty obese and 25 control children of 11.2+/-1.8 y of age. Measurements: TBW and ECW were assessed by deuterium and bromide dilution; Z was measured at frequencies of 5, 50 and 100 kHz. Results: In controls, Wt explained 11% more variance of TBW than ZI (r(2)=0.977, SEE=0.9 I, CV=3.8%) and the association of Wt and ZI improved the prediction of TBW only slightly (r(2)=0.982, SEE=0.8 I, CV=3.5%). The SA:Z and V:Z indexes explained 6 and 33% less variance of TBW respectively as compared to Wt alone. In obese subjects, ZI explained 4% more variance of TBW than Wt (r(2)=0.914, SEE=1.8 I, CV=6.4%) and the SA:Z ratio was the most accurate predictor of TBW (r(2)=0.959, SEE=1.2 l, CV=4.4%). However, the increase in the explained variance of TBW associated to the use of the SA:Z ratio was of only 1% as compared to the association of ZI and Wt. The V:Z ratio explained 9% less of variance of TBW as compared to ZI. In both control and obese subjects, the association of Wt and ZI offered the best prediction of ECW (r(2)=0.807, SEE=1.564 I and r(2)=0.826, SEE=1.035 I, respectively). However, the values of CV were much higher in controls than in obese children (17.5% vs 8.4%) owing to their lower ECW and greater variability in ECW%. ZI was the most accurate predictor of TBW on the pooled sample (n=55; r(2)=0.910, SEE=1.932 I, CV=7.4%). However, it was a poor predictor of ECW on the same sample owing to its high CV (n=55; r(2)=0.866, SEE =1.806 I, CV=17.0%). Conclusions: The body surface area to impedance ratio is the most accurate predictor of TBW in obese children but the association of ZI and Wt may be of more interest when BIA is used to estimate both TBW and ECW. The impedance index offers a good prediction of TBW but not of ECW in children with different levels of fatness

Dose-dependent effect of octreotide on insulin secretion after OGTT in obesity

Objective: The present study aimed at evaluating the acute effect of increasing doses of octreotide (OCT), a long-acting somatostatin analogue, on glucose tolerance and insulin secretion. Methods: A standard and two other oral glucose tolerance tests 30 min after subcutaneous administration of OCT were performed in randomized order in each subject. Obese subjects received 10, 25, or 50 mu g of OCT; control subjects received only 10 and 25 mu g. Fifteen obese and 10 control subjects were studied; all of them had a normal glucose tolerance. Plasma glucose and insulin levels were measured at times -30, 0, 30, 60, 90, 120, 150, and 180 min after the glucose tolerance test. Results: The results demonstrated that, following OCT administration, both control and obese subjects developed a reduced glucose tolerance, a delayed glycemic peak, and an increase of late plasma glucose values. Fasting as well as stimulated insulin secretions were higher in obese subjects as compared with controls, and insulin secretion was inhibited in a dose-dependent manner by OCT. Conclusions: These data indicate that the action of OCT might be due to at least two different cooperative mechanisms: (1) a delayed glucose absorption, as suggested by the delay of glycemic peak, and (2) a direct or vagal-mediated effect on p-cells, as suggested by the reduction of the area under the curve values in spite of the elevated late glycemic levels. It is noteworthy that doses of OCT as low as 10 and 25 mu g are sufficient to inhibit insulin secretion both in normal and obese subjects

Dose-dependent effect of octreotide on insulin secretion after OGTT in obesity

The present study aimed at evaluating the acute effect of increasing doses of octreotide (OCT), a long-acting somatostatin analogue, on glucose tolerance and insulin secretion

Densitometric evaluation in women with anorexia nervosa

Anorexia nervosa (AN) is classified as a high-risk factor for osteoporotic fractures. Dual X-ray absorptiometry (DXA) is the most popular method for measuring bone loss, but it is less sensitive than quantitative computed tomography (QCT). We compared DXA and QCT in measuring the lumbar spine of 17 female patients with AN and 27 healthy subjects. We found discordance between DXA and QCT using World Health Organization (WHO) criteria with the T-score. With QCT as a reference method because of its sensitivity, we found one false-negative, one false-positive, and two misdiagnosed cases. We suggest some correction factors to improve DXA evaluation and screening of bone loss in AN